Colorado Medicaid offers broader coverage than many private plans

A new Common Sense Institute report says Colorado’s Medicaid program covers more medical services than the typical private health insurance plan.

The analysis examined coverage in 88 categories of medical services under Health First Colorado, the state’s Medicaid program, along with individual marketplace plans and large-group employer-sponsored insurance. Health First Colorado covered as many as 80 of the 88 services, while individual marketplace plans covered an average of 65 and employer-sponsored plans covered 62.

Among the services covered by Health First Colorado but not usually included in individual or employer plans are non-emergency medical transportation, long-term or custodial nursing facility care, and equine therapy.

Medicaid now makes up the largest share of the state budget, consuming about one-third of every dollar spent. Enrollment has risen more than five times over the past two decades, and spending went $158 million over budget last year with no indication of slowing.

“Due in particular to changes that have materialized over just the last several years, the state currently offers Medicaid plans that, despite being taxpayer-funded and crowding out other spending priorities, are in many ways appreciably more generous than those offered to working people,” the report says. “Limited cuts to Medicaid’s benefits package, alongside other practical reforms of the state’s systems, could help save Colorado enough money in the short term to accommodate the looming loss of federal funding.”

Lawmakers created the Commission on Medicaid during the most recent legislative session. The bipartisan panel is tasked with identifying, considering and evaluating legislative and executive branch options to create a sustainable Medicaid program.

Sen. Judy Amabile, D-Boulder, who chairs the commission, said the fastest-growing spending categories are long-term services and supports, pharmacy benefits, behavioral health and administrative costs.

She told Colorado Politics news partner 9News that the program serves “kids with very serious and complicated disabilities, kids who are in wheelchairs and need trach tubes, kids who are on oxygen, kids who need 24/7 care, as well as older people who need nursing home-level of care.”

If Medicaid spending continues to climb, budget writers will have to trim funding for other major priorities such as K-12 and higher education, Rep. Emily Sirota, D-Denver, who leads the General Assembly’s Joint Budget Committee, told Colorado Politics.

Those areas have already seen reductions, including an $82 million cut to the Department of Education and a $2 million cut to the Department of Agriculture.

“We are having to make cuts that will impact people’s lives, but we are doing them in the most compassionate and evidence-based way,” Rep. Kyle Brown, D-Louisville, said during a Joint Budget Committee meeting last spring.